This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Abstract of project: Experiments are being conducted to develop an appropriate dietary supplement directly addressing malnutrition in sickle cell anemia (SCA) pathology. A supplementation study conducted over 4 months, will test the efficacy of the supplement. Measurements include indirect calorimetry, anthropometry, body composition by Dual X-Ray Absorptiometry (DEXA) and circulating levels of inflammatory proteins by luminex assay in undernourished children (6 [unreadable]12 y) with SCA and healthy controls. Specific aims are: 1. to develop a customized nutritional supplement for SCA children, based on estimated requirements for excessive protein and energy metabolism plus specific amino acid deficiencies and 2. to investigate the efficacy of the supplement in undernourished SCA children by measuring temporal changes in resting energy expenditure;reticulocyte count;weight, height and body composition;circulating amino acids;markers of oxidant damage;Pro- and anti-inflammatory protein.